Education And Debate

Recruiting doctors from poor countries: the great brain robbery?

BMJ 2003; 327 doi: (Published 16 October 2003) Cite this as: BMJ 2003;327:926
  1. Vikram Patel, senior lecturer (
  1. 1London School of Hygiene and Tropical Medicine, London WC1E 7HT
  1. Correspondence to: V Patel, Sangath Centre, 841/1 Alto Porvorim, Goa 403521, India
  • Accepted 7 August 2003

An important impediment to achieving health for all in developing countries is the shortage of doctors and nurses. Can the NHS justify schemes to recruit staff from these countries?

An enormous gap in health staffing exists between the United Kingdom and India. India has fewer than 3000 psychiatrists for its one billion population compared with one psychiatrist for every 9000 people in the United Kingdom, a 27-fold difference.1 Despite this inequality, the NHS has launched a scheme to recruit senior psychiatrists and other specialists from India and other developing countries. This scheme will worsen the brain drain and inequities in global health unless it is explicitly linked with measures to enable the flow of doctors back to developing countries.

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Waiting for treatment: shortage of medical staff is an important barrier to health in India


Opportunities or opportunism?

Overseas recruitment schemes are marketed primarily as an opportunity for doctors to experience one of the world's best healthcare systems. Yet it is obvious that the NHS is trying to fill jobs in specialties where there is a shortage of staff. Although shortages are acknowledged in the promotional material for the new NHS international fellowship scheme, the difficulties that doctors will face when they attempt to return home are ignored. Experience with …

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